Endo

Question 1

HBA1C target in T1DM

Answer 1

48

Question 2

CBG targets in T1DM

Answer 2

5-7 waking
4-7 before meals

Question 3

Clinical triad in Primary Hyperaldosteronism

Answer 3

Hypertension
Hypokal
Metabolic alkalosis (high bicarb)

Question 4

First line investigation in primary hyperaldosteronism

Answer 4

aldosterone/renin ratio

Question 5

Impaired fasting glucose levels

Answer 5

> =6.1 < 7.0 = IFG

Question 6

Impaired glucose tolerance

Answer 6

fasting glucose < 7
OGTT >=7.8 < 11.1

Question 7

How often should A1C be checked in T2DM

Answer 7

3-6 months > stable > 6 monthly

Question 8

What are HBA1C targets for lifestyle, lifestyle + metformin, use of nay drug which can cause hypoglycaemia

Answer 8

Lifestyle - 48 (6.5)
Lifestyle + metformin - 48 (6.5)
Hypo drug 53 (7)

Question 9

Which drug should be added to metformin in the first line management to T2DM and under what circumstances?

Answer 9

SGLT-inhibitor

High risk / established CVD or chronic heart failure

Question 10

Which are the SGL2 inhibtors

Answer 10

-flozins (think glucose floze out)

Question 11

Which drug class are ‘the gliptins’

Answer 11

DPP4 inhibitors

Question 12

How do sGL2 inhibitors work

Answer 12

Blocks SGL2 enzymes in the kidney = no glucose reuptake

Question 13

DPP4i MOA

Answer 13

blocks incretin > increased insulin secretion

Question 14

Which diabetic drug class have drugs which end in -ide

Answer 14

sulfonylureas

Question 15

This drug increases insulin production and secretion from the pancreas by binding K channels

Answer 15

sulfonylureas (-ide)

Question 16

What is th next step in a patient who is allergic to metformin?

Answer 16

either SLT2 mono therapy if there is CVD/CHF
or
DPP4i , pioglitazone, sulfonyurea

Question 17

Which drugs end in -tide

Answer 17

GLP1 mimetics

Question 18

When should GLP1s be used

Answer 18

When insulin is contraindicated due to employment or if bMI > 35

Question 19

What are the side effects of pioglitazone (thiazolidenediones)

Answer 19

weight gain
lIver impairment
fluid retention > not to be used in heart failure
fracture risk
bladder ca

Question 20

What are the diagnostic criteria for T2DM

Answer 20

symptomatic FASTING >= 7
symptomatic RANDOM >=11
A1C > 48

Question 21

Which conditions do not allow for diagnosis of T2DM with A1C only

Answer 21

haemoglobinopathies
haemolytic anaemia
untreated iron def
gestational diabetes
children
hiv
ckd
anything that causes hyperglycaemia

Question 22

Which drugs can cause gynacomastia

Answer 22

ranitidine
isoniazid
digoxin
spiro (most common cause)
GnRH agonists (goserelin)

Question 23

Which drug can cause glaactorrhoea

Answer 23

chlorpromazine
metoclopramide
domperidone
haloperidol

Question 24

From lowest to highest glucocorticoid activity - steroids

Answer 24

Low

fludro
hydro
pred
dex / betamethasone

High

Question 25

Which patient should be started on 25mcg of levothyroxine?

Answer 25

> 50 Severe hypothyroidism Cardiac disease

Question 26

How much should the dose of levo be increased by in pregnancy?

Answer 26

25-50mcg

Question 27

Side effects of levo

Answer 27

hyperthyroidism low bone mineral density angina AF

Question 28

How does carbimazole work?

Answer 28

Blocks thyroid peroxidase

Question 29

Which conditions can increase the A1C level

Answer 29

B12/folate def iron def splenectomy

Question 30

Treatment of proalactinomas

Answer 30

1. medical therapy with dopamine agonists (cabergoline, bromocriptine) 2, Surgery if cannot tolerate or fail to respond to medical therapy

Question 31

Which drug can reduce the absorption of levo

Answer 31

iron/calcium

Question 32

Why should amitryptiline not be issued if there is BPH

Answer 32

increased risk of urinary retention

Question 33

Clinical features of Addisons

Answer 33

hyperpigmentation hyperkalaemia hypotension hyponatraemia jf Kennedy had addisons

Question 34

Investigation for addisons

Answer 34

short synachten test (ACTH stmulation test)

Question 35

PTH levels in primary hyperparathyroidism

Answer 35

high or normal

Question 36

Electrolyte findings in primary hyperPTH

Answer 36

high Ca low ph

Question 37

Addisons is also known as what

Answer 37

primary HYPOaldosteronism

Question 38

Primary Hyperaldosteronism is also known as what

Answer 38

Conn's

Question 39

C peptide levels are low in T1DM T or F

Answer 39

True

Question 40

Typical presentation of myxoedema coma

Answer 40

confusion and hypothermia

Question 41

Features of addisonian crisis

Answer 41

malaise nv ado pain muscle cramps paraesthesia

Question 42

Management of acromegaly

Answer 42

1. Trans sphenoidal surgery 2. Octreotide (somatostatin analogue)

Question 43

Pioglitazone should not be prescribed in which situations

Answer 43

heart failure

Question 44

Which drug can mask the symptoms of hypoglycaemia

Answer 44

beta blockers

Question 45

sulfonylureas can case weight gain

Answer 45

true

Question 46

Causes of acanthuses nigrans

Answer 46

type 2 diabetes mellitus gastrointestinal cancer obesity polycystic ovarian syndrome acromegaly Cushing's disease hypothyroidism familial Prader-Willi syndrome drugs combined oral contraceptive pill nicotinic acid

Question 47

Interpretation of serum 9am cortisol test

Answer 47

> 500 nmol/l makes Addison's very unlikely < 100 nmol/l is definitely abnormal 100-500 nmol/l should prompt a ACTH stimulation test to be performed

Question 48

Anti Jo positive in

Answer 48

Dermatomyositis

Question 49

Anti Jo antibodies are also known as

Answer 49

Anti histidine tRNA ligase

Question 50

ANA positive + Anti Jo positive

Answer 50

Dermatomyositis

Question 51

Antibody test in drug induced lupus

Answer 51

Antihistone